A Study of Early Diagnostic Markers in Peripheral Blood of Patients with Cholangiocarcinoma Based on Key Immune Cell Subsets
Objective To explore early diagnostic markers in peripheral blood of patients with cholangiocarcinoma based on key immune cell subsets.Methods From May,2021 to May,2023,75 patients diagnosed with CCA in our hospital were collected as the CCA group,while 75 patients with cholangitis admitted to our hospital were regarded as the control group.During the same period,75 healthy volunteers in our hospital were enrolled as the healthy group.Flow cytometry was applied to detect levels of CD3+,CD4+,CD8+,and CD4+/CD8+;Enzyme linked immunosorbent assay(ELISA)was conducted to detect levels of tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),and γ-interferon(IFN-γ).Pearson method was applied to evaluate correlations between CD3+,CD4+,CD4+/CD8+levels and TNF-α,IL-2,IFN-γ levels in CCA patients;ROC curve was drawn to evaluate values of peripheral blood immune cell subsets for the diagnosis of CCA.The influencing factors of CCA were identified by logistic regression.Results Compared with the healthy group,levels of CD3+,CD4+,CD4+/CD8+in control group and CCA group were significantly increased;Compared with the control group,levels of CD3+,CD4+and CD4+/CD8+in CCA group were significantly increased(P＜0.05).Compared with the healthy group,levels of IL-2 and IFN-γ in the control group and CCA group were significantly decreased,while levels of TNF-α were significantly increased;Compared with the control group,levels of IL-2 and IFN-γ in CCA group were significantly decreased,while the levels of TNF-α were significantly increased(P＜0.05).Correlation analysis showed that the levels of CD3+,CD4+,CD4+/CD8+in CCA patients were negatively correlated with IL-2 and IFN-y,but positively correlated with TNF-α(P＜0.05).AUC value of the combined detection of peripheral blood immune cell subsets(CD3+,CD4+,CD4+/CD8+,TNF-α,IL-2,IFN-γ)for the diagnosis of CCA was significantly higher than that of the single-marker diagnosis(ZCD3+vscombination=4.424,P＜0.001;ZCD4+vs combination=3.425,P=0.001;ZCD4+/CD8+vs combination=4.502,P＜0.001;ZTNF-α vs combination=3.322,P＜0.001;ZIL-2 vs combination=7.473,P=0.001;ZIFN-γ vs combination=3.166,P=0.001).Multivariate logistic regression analysis showed that levels of CD3+,CD4+,CD4+/CD8+,IL-2,and IFN-γ were the influencing factors on the occurrence of CCA(P＜0.05).Conclusion The level of peripheral blood immune cell subsets in patients with CCA is significantly increased,and the combination of these subsets could improve the diagnostic efficiency of CCA occurrence.
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